Neuropsychiatric adverse events of antiepileptic drugs in brain tumour-related epilepsy: an Italian multicentre prospective observational study
Autor: | Paolo Calabresi, Michele Romoli, Sabrina Dispenza, Marta Maschio, Chiara Bedetti, S. Siliquini, C. Di Bonaventura, Paolo Eusebi, Cinzia Costa, E. Nardi Cesarini |
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Jazyk: | angličtina |
Rok vydání: | 2017 |
Předmět: |
Adult
Male medicine.medical_specialty Levetiracetam brain tumour-related epilepsy neuropsychiatric adverse events adverse effect antiepileptic drugs epilepsy primary brain tumour Neurology Neurology (clinical) Young Adult 03 medical and health sciences Epilepsy 0302 clinical medicine Internal medicine medicine Humans Prospective Studies Young adult Psychiatry Prospective cohort study Adverse effect Aged Aged 80 and over Brain Neoplasms business.industry Odds ratio Middle Aged medicine.disease Piracetam Treatment Outcome Italy Frontal lobe 030220 oncology & carcinogenesis Anticonvulsants Female Neurosurgery business 030217 neurology & neurosurgery medicine.drug |
Popis: | Background and purpose We assessed the prevalence and magnitude of neuropsychiatric adverse events (NPAEs) associated with antiepileptic drugs (AEDs) among patients with brain tumour-related epilepsy (BTRE). Methods This observational, prospective, multicentre study enrolled 259 patients with BTRE after neurosurgery. All patients received AED monotherapy. Efficacy was assessed through clinical diaries, whereas NPAEs were collected using the Neuropsychiatric Inventory Test-12 questionnaire at baseline and after 5 months. Results Tumour localization in the frontal lobe was associated with a higher prevalence of NPAEs (odds ratio, 7.73; P < 0.001). Independent of tumour localization, levetiracetam (LVT) treatment was associated with higher prevalence and magnitude of NPAEs (odds ratio, 7.94; P < 0.01) compared with other AEDs. Patients with oligodendroglioma reported more NPAEs than patients with other tumour types. NPAEs were not influenced by chemotherapy, radiotherapy or steroid treatment. Evaluating non-neurobehavioural adverse events of AEDs, no significant differences were found among AEDs, although patients treated with old AEDs had a higher prevalence of adverse events than those treated with new AEDs. Conclusions Both tumour localization in the frontal lobe and LVT treatment are associated with a higher risk of NPAEs in patients with BTRE. LVT is regarded as a first-line option in patients with BTRE because of easy titration and few significant drug-to-drug interactions. Thus, as NPAEs lead to poor compliance and a high dropout rate, clinicians need to accurately monitor NPAEs after AED prescription, especially in patients with frontal lobe tumours receiving LVT. |
Databáze: | OpenAIRE |
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